Objective To observe the effect of irbesartan on the expression of angiopoietinlike protein 2 (ANGPTL2) in the diabetic rats kidney and explore the underlying mechanism.Methods A total of sixty male SD rats were divided into normal control group (NC group,n=15) and experimental group (n=45) randomly.The experimental group was fed with high sugar-fat diet and given a low dose streptozocin (STZ 30 mg/kg)to establish type 2 diabetic model.Rats successfully induced diabetes were randomly divided into 2 groups:diabetes group (DM) and irbesartan group (DI).Weight,blood pressure,blood glucose,serum creatinine (Scr),blood urea nitrogen(BUN),24 hour urinary albumin(UAL) and renal histomorphology were observed after drug intervention at the 4th,8th and 12thweeks.The expression of ANGPTL2 in renal tissue were detected by immunohistochemistry,real-time PCR and Western blotting.Results The levels of Scr,BUN,TG,TC and UAL in group DM were higher than in group NC at the 4th,8th and 12th week (all P ＜ 0.05).Compared with that in group DM,above indexes were lower in group DI at the 4th,8th and 12th week (all P ＜ 0.05).The pathological changes of the kidney in group DM were more serious than that in group DI.The expression of ANGPTL2 in group DM was much higher than that in group NC at the 4th,8th and 12th week (all P ＜0.05),and irbesartan treatment inhibited the up-regulation of ANGPTL2 in group DI(all P ＜ 0.05).Conclusion The expression of ANGPTL2 increases in T2DM rats kidney tissue with time and irbesartan can inhibit the up-regulation of ANGPTL2 in T2DM rats.

OBJECTIVETo investigate the clinical effectiveness of sertraline hydrochloride combined with four-spot caress in the treatment of primary premature ejaculation (PE).

METHODSWe randomly assigned 90 primary PE patients to three groups of equal number. The patients in group A (aged [28.1 ± 5.2] yr and with a disease course of [3.1 ± 1.9] yr) were treated with oral sertraline hydrochloride at 50 mg qd, those in B (aged [27.8 ± 4.1] yr and with a disease course of [3.2 ± 2.0] yr) by four-spot caressing (caressing the tongue, breasts, and vulva prior to intercourse), and those in C (aged [27.1 ± 4.7] yr and with a disease course of [3.1 ± 2.0] yr) by the combination of oral sertraline hydrochloride and four-spot caressing, all for 12 weeks. Before and after 4, 8, and 12 weeks of treatment, we obtained the intravaginal ejaculatory latency time (IELT) and Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores and compared them among the three groups of patients.

RESULTSThe IELT was dramatically prolonged in groups A, B, and C after 4 weeks ([1.08 ± 0.29], [0.93 ± 0.28] and [1.21 ± 0.27] min), 8 weeks ([1.43 ± 0.30], [1.20 ± 0.33] and [1.72 ± 0.42] min) and 12 weeks of treatment ([2.12 ± 0.63], [1.90 ± 0.65] and [2.67 ± 0.82] min) as compared with the baseline ([0.63 ?0.14] , [0.60 ?0.14] and [0.62 ?0.11] min) (P < 0.05), even longer in group C than in A and B (P < 0.05). The CIPE-5 scores were markedly improved in groups A, B and C after 4 weeks ([15.17 ± 1.74], [14.57 ± 1.94] and [15.60 ± 1.63] min), 8 weeks ([17.13 ± 1.63], [16.37 ± 1.97] and [18.00 ± 1.05] min) and 12 weeks of intervention ([18.93 ± 1.57], [18.53 ± 1.67] and [20.00 ± 1.46] min ) as compared with the baseline ([12.57 ± 2.05], [13.20 ± 2.51] and [13.07 ± 2.01] min) (P < 0.05), even higher in group C than in A and B (P < 0.05).

CONCLUSIONSertraline hydrochloride combined with four-spot caressing, with its definite efficacy and rare adverse reactions, deserves wide clinical application in the treatment of primary PE.

Adult ; Coitus ; Ejaculation ; Female ; Humans ; Male ; Premature Ejaculation ; drug therapy ; Sertraline ; therapeutic use ; Young Adult

Objective To investigate the CT performances and causes of misdiagnosis of parovarian cyst,to improve its diagnostic accuracy.Methods CT data of 75 patients with surgically and pathologically confirmed parovarian cyst were analyzed retrospectively. Results Among the 75 patients,there were 79 cysts,in which 48 patients (51 cysts)originated from the epoophoron and 27 patients (28 cysts) from the mesosalpinx.77 were simple serous cysts and 2 serous cystadenomas.38 were located in the right ovarian adnexa,36 in the left ovarian adnexa,3 in the anterosuperior uterus,1 in the rectouterine pouch and 1 in the right iliac fossa.The size of the cysts ranged from 10 mm × 13 mm to 174 mm × 227 mm.75 were single cysts and 4 double cysts,34 presented as ovoid cysts,25 as irregular cysts, 17 as round cysts and 3 as gourd-shaped cysts.All the 79 cysts showed clear boundaries,thin walls,non-mural nodules,cystic fluid with a homogeneous densitywith CT value of 0-31 HU.Enhanced scanning revealed curved “obvious enhancement of the fallopian tube”at the edge of 68 cysts.In addition,the ipsilateral ovary could be detected in 76 cysts.“Holding ball”was found in 1 9 cysts.Conclusion Indication in ipsilateral ovary,curved “obvious enhancement of the fallopian tube”at the edge of cysts and “holding ball”are distinctive CT performances of parovarian cysts.CT has an important diagnostic value in parovarian cyst.

Objective To evaluate the effects of sufentanil on regeneration and repair after single sciatic nerve injury in mice. Methods Seventy?five healthy male BALB∕c mice, aged 6-8 weeks, weig?hing 18-22 g, were divided into 5 groups ( n=15 each) using a random number table: peripherial nerve injury group (group PNI), low, medium and high doses of sufentanil groups (L, M and H groups) and cyclosporine A group ( group C) . The model of unilateral sciatic nerve transection was established in the 5 groups. In L, M and H groups, sufentanil 2?5, 5?0 and 10?0 μg∕kg were injected intraperitoneally, re?spectively, once a day for 3 consecutive days. Cyclosporine A 50 mg∕kg was injected intraperitoneally once a day for 3 consecutive days in group C. The equal volume of normal saline was given once a day for 3 con?secutive days in group PNI. Neurophysiological monitoring was performed at 4, 8 and 12 weeks after opera?tion, the amplitude of compound muscle action potentials of the sciatic nerve was recorded, and the nerve conduction velocity was measured. At 8 weeks after operation, 5 mice were sacrificed, the sciatic nerve 0?5 cm of the upper and lower the anastomosed site was removed for examination of the morphology of myelin sheath with light microscope, and the number of nerve fibers was calculated. Results Compared with group PNI, the amplitude of compound muscle action potentials of the sciatic nerve, nerve conduction ve?locity and the number of nerve fibers was were significantly increased in M, H and C groups ( P<0?05) , and no significant change was found in the parameters mentioned above in group L ( P>0?05 ) . Myelin sheath arrangement was severely irregular, and more vacuoles were found in group PNI. Myelin sheath ar?rangement was irregular, and more vacuoles were found in group L. Myelin sheath arrangement was mainly regular, and vacuoles were found occasionally in group M. Myelin sheath arrangement was regular, and no vacuoles were observed in H and C groups. Conclusion Sufentanil can promote regeneration and repair af?ter peripheral nerve injury in mice.

Objective To explore the protective effect of recombinant superoxide dismutase(SOD)fusion protein against the infection of Schistosoma japonicum Chinese strain.Methods The recombinant SOD fusion protein was expressed and purified with Glutathione sepharose 4B.C57BL/6J mice were immunized with the recombinant SOD fusion protein mixed with Freund adjuvant.Four weeks after the final immunization,the mice of the experiment and control groups were challenged with(45?2)S.japonicum cercariae.All the mice were sacrificed on the forty-fifth day after the challenge to calculate the worm reduction rate and egg reduction rate,and to observe the pathologic changes of liver tissue of the mice.Results The worm reduction rate was 35.63% and the egg reduction rate was 31.17% in the experiment group.The number of granuloma in the live tissue of the experiment group was less than that of the control group,and the mean diameter of single granuloma in the experiment group reduced by 22.32% compared with that of the control group.The IgG subclass levels of IgG1,IgG2a,IgG2b were higher than those of the control group.Conclusion The recombinant SOD fusion protein has a protective effect against Schistosoma japonicum infection.

Stroke is responsible for increasingly high rates of mortality and disability worldwide. Approximately two million people suffer from stroke for the first time in China each year. The high incidence (50%) of post-stroke disability brings a heavy burden to patients and their caregivers. Acupuncture has been widely used in the communities for post-stroke rehabilitation in China. The objective of this trial is to apply our acupuncture research achievement to treatment and evaluation of post-stroke hemiplegic patients in community.

Objective To study the potential of multi-slice spiral CT perfusion imaging in the assessment of cerebral neoplasms.Methods Multi-slice helical CT perfusion imaging was performed in 38 patients with cerebral tumors.The perfusion imaging of the tumor was carried out by cine scan technique (ls/1 rotation) with slice thickness 5 mm/4i,reconstructed slice thickness 10 mm/2i.Contrast injection was done by using 50 ml nonionic contrast agent(300 mg I/ml),at a flow rate of 3.5 ml/s with a power injector,and 5 seconds delay,and data acquisition lasted for 45 seconds.The scanning images were processed in ADW 4.0 workstation.BF、BV、PS values of tumors were calculated and statistically analysed. Results 38 patients with cerebral neoplasms included 9 cases of gradeⅠ—Ⅱgliomas(group 1),10 cases of gradeⅢ—Ⅳgliomas (group 2),9 eases of metastases (group 3)and 10 cases of meningiomas (group 4).All raw data was transformed to square root so as to be consistent with normal distribution.BF~(1/2) values for groupl to group 4 were (5.99?1.03)、(7.55?1.57)、(7.72?2.02 )、(11.40?2.13)ml?rain~(-1)?kg~(-1).The differences in BF~(1/2) were statistically significant between group 1 and group 2,between group 1 and group 3,between group 1 and group 4,between group 2 and group 4,between group 3 and group 4(t_(1,2)=6.89,t_(1,3)=4.59,t_(1,4)=11.03,t_(2.4)=10.58,t_(3,4)=7.65,P＜0.05),and there was no statistically significant difference between group 2 and group 3(t_(2.3)=1.17,P＞0.05);BF~(1/2) values for groupl to group 4 were (1.01?0.19)、(1.42?0.38)、(1.25?0.33)、(1.60?0.24)ml?kg~(-1).The differences in BF~(1/2) were statistically significant between every two groups (t_(1,2)=7.15,t_(1.3)=3.71, t_(1.4)=5.93,t_(2.3)=2.94,t_(2,4)=2.72,t_(3.4)=4.46,P＜0.05 );PS~(1/2) values for groupl to group 4 were (1.70?0.37)、(3.63?0.95)、(4.29?1.30)、(5.69?1.03)ml?min~(-1)?kg~(-2).The differences in PS~(1/2) were statistically significant between every two groups(t_(1.2)=11.53,t_(1.3)=10.61,t_(1.4)=16.77,t_(2.3)=3.69, t_(2,4)=9.94,t_(3,4)=5.52,P＜0.05).Conclusion Multi-slice helical CT perfusion imaging is very useful to evaluate tumor vessels of cerebral neoplasmas and it can provide information of incremental benefit in diagnosis,in staging of tumor grade,in the distinction of benign from maglignant cerebral neoplasmas and in differentiating intracerebral neoplasmas from extracerebral neoplasmas.

OBJECTIVE: To summarize the pattern and main characteristics of fatal cases related to medical disputes in Yancheng area. METHODS: Sixty fatal cases of medical disputes were retrospectively analyzed to elucidate the annual incidence, characters of distribution of hospitals, gender and age of the decedents, types of diseases, and cause of death. RESULTS: Among 60 fatal cases, most cases happened in health clinics of county, township and village. There were more males than females. The major medical specialties involved included internal medicine, surgery, gynecology and pediatrics, with the internal medicine specialty having the highest incidence. CONCLUSION Police institutions have advantages in investigation of these cases in their jurisdictions, which could enhance the ability of local medicolegal examination.
Autopsy ; Cause of Death ; Dissent and Disputes ; Environment ; Female ; Forensic Medicine ; Humans ; Incidence ; Male ; Medicine ; Police ; Retrospective Studies

OBJECTIVE:To investigate the effects of neoadjunctive chemotherapy(NAC)of docetaxel and epirubicin com-bined with cyclophosphamide on clinical efficacy and tumor markers of breast cancer patients with different molecular types. METH-ODS:A total of 88 female patients with locally advanced breast cancer collected from our hospital during Jan. 2014-Jan. 2016 were divided into Luminal A type(23 cases),Luminal B type(21 cases),basal-like type(11 cases),HER2-over expressing type(18 cases)and normal breast-like type(15 cases)according to molecular type. All patients were given Docetaxel injection+Epirubicin hydrochloride injection+Cyclophosphamide for injection for consecutive 6 cycles(21 d as a cycle). Total response rates and patho-logical complete remission(pCR)rates were compared among breast cancer patients with different molecular types. The expression of serum tumor markers [CEA,CA125,CA153] were compared before and after treatment,and the occurrence of ADR was record-ed. RESULTS:Total response rate of 88 patients was 63.64%,among which that of basal-like breast cancer patients was 72.73%, significantly higher than other molecular types,with statistical significance(P<0.05). There was no statistical significance in total response rates of pairwise molecular type comparison(P>0.05). The pCR rate of 88 patients was 27.27%,and that of basal-like breast cancer patients was the highest(45.45%). There was statistical significance in pCR rates of pairwise molecular type compari-son(P<0.05),except there was no significant difference in pCR rate between HER2-over expressing type and normal breast-like type(P>0.05). Before treatment,there was no statistical significance in the expression of CEA,CA125 and CA153 in breast can-cer patients with different molecular types(P>0.05). After treatment,the expression of CEA,CA125 and CA153 in different mo-lecular types were decreased significantly,with statistical significance(P<0.05). There was no statistical significance in the expres-sion of above markers among different molecular types(P>0.05). There was no statistical significance in the incidence of ADR among different molecular types(P>0.05). CONCLUSIONS:NAC plan of docetaxel and epirubicin combined with cyclophospha-mide can reduce the expression of tumor markers and shows certain therapeutic efficacy for breast cancer patients with different mo-lecular types. Total response rate and pCR rate of basal-like type are better than those of other molecular types,so NAC plan is the preferred treatment for basal-like type breast cancer.